Journey to the BRS-S

It’s official!  I finally did it and am so extremely happy and excited!!

I finally, not only had my application accepted by the BRS-S (Board Recognized Specialty in Swallowing and Swallowing Disorders) and passed the exam.  I can officially put the title BRS-S after my credentials!

I wish that I could say that it was an easy process, but it really wasn’t.  I will say though that I have learned so much along the way and have met so many new and wonderful process through this amazing journey.

The main reason for writing this post is to, hopefully encourage others to do the same.  This was something to me that several years ago seemed completely unreachable.  I mean really, I’ll never compare to the Jeri Logemanns of the world!

Many people have asked me about applying for and taking the exam for the BRS-S.  Here is post about my experience.

I had went to many conferences and saw speakers with BRS-S after their names.  I went to the website, www.swallowingdisorders.org, and started looking into what it would take to become BRS-S.  WOW!  Not only do you have to prove that you have gone over and beyond in the area of swallowing and dysphagia, but you have to have 75 CEU’s in dysphagia, 3 years experience post graduation and letters of recommendation.

The BRS-S does offer the opportunity to utilize a mentor during the entire process.  I decided that it wouldn’t hurt to look into a mentor to even see if this is something possible for me.  I actually did, 2 years ago, I applied for a mentor.  I ended up with Nancy Swigert, who I truly can never thank enough for not only giving me the courage and the confidence to believe that I could do this, but also endlessly reviewed and helped my revise my very very very long application.

If you are looking into applying for BRS-S, the website has the following listed as requirements:

Requirements for all applicants

1. ASHA Certification.

All applicants must currently hold the ASHA Certificate of Clinical Competence in Speech-Language Pathology (CCC/SLP).

2. Continuing Education.

All applicants must document receipt of at least 7.5 CEUs that relate to dysphagia within the last 3 years. A minimum of 4.5 of the CEUs need to be ASHA sponsored courses and up to 3.0 of the CEUs may be non-ASHA sponsored continuing education activities.
Individuals attending workshops which do not give ASHA CEUs may apply for independent study through ASHA to receive ASHA CEUs. Please provide evidence of attendance at other educational activities in closely related fields. Detailed descriptions of all non-ASHA sponsored CEU activities is required. Continuing education activities may include
  • Workshops, meetings or courses in swallowing and swallowing disorders, video and audio courses, telemedicine, and other electronic media)
  • Independent study (e.g., course development, research projects, publications, internships)
  • Self-study (e.g., videotapes, audiotapes, journals).
Continuing education courses must be directly related to dysphagia. If the title of the course is unclear (as it relates to dysphagia), an applicant should submit a program or brochure to provide substantiation for its inclusion.
When applying CEUs from the ASHA National convention or other multi-offering events, applicants must list specific course/workshop titles and corresponding CEUs in the application table. CEUs will be applied for only those courses/workshop relative to dysphagia.
College Courses.  If an applicant has completed a college level course in dysphagia, accrued credits can be applied to continuing education requirements. Graduate university coursework must be accompanied by a syllabus or transcript. One college credit is equivalent to 1 CEU (as it relates to application for BRS-S). The applicant must submit a transcript or other document verifying completion of those credits.
Instructor or Invited Lecturer. If an applicant teaches a dysphagia course at an approved university/college or provides dysphagia-related lectures at a conference which provides ASHA CEUs, a maximum of 3.5 CEUs may be applied to the 7.5 CEU requirement for BRS-S. One college credit is equivalent to 1 CEU. Each course may only be applied only one time within an application (even though the same course/conference may be taught several times during an academic year or in consecutive years). The applicant must submit appropriate evidence and documentation of the lectures that were related to dysphagia.

3. Post-Certification Clinical Experience.

All applicants must have completed a minimum of 3 years post certification (CCC/SLP) clinical work that has a focus in dysphagia. BRS-S has established two tracks to meet the diversity of clinical service environments for professionals at all levels of advancement within the profession:Clinical Track and Academic/Administrative Track.  The Clinical Track looks to identify professionals who demonstrate strong advanced clinical skills through direct provision of services to patients/clients. The Academic/Administrative Track looks to identify researchers, instructors and administrators who have advanced in different employment environments. These individuals maintain clinical skills through ongoing patient/client contact, while promoting improved patient care through research and teaching/training of clinicians within this specialized area of practice.
a. Clinical Track: a minimum of 350 clock hours of evaluation and/or treatment of swallowing disorders completed within a year for each of 3 years prior to applying for BRS-S. Supervision of speech-language pathology staff members and students providing evaluation and treatment to infants, children or adults with feeding and swallowing disorders can account for 100 of the required 350 hours/year. Supervisors must submit a statement affirming that all of the 100 hours of supervision were for dysphagia cases. The balance of the hours must be obtained from direct face-to-face clinical service to patients.
b. Academic/Administrative Track: a minimum of 100 clock hours of clinical evaluation and/or treatment of persons with swallowing disorders completed within a year for each of 3 years prior to applying for BRS-S. These hours must all be direct patient contact hours.
In place of the higher number of clock hours required of those in the Clinical track, applicants in the Academic/Administrative tract shall hold either:
a. an academic position in a degree-granting institution with a combination of teaching, and research, and academic advising with a focus on swallowing and swallowing disorders. Evidence of student advising, teaching, and research must be included in the narrative section of this application. Evidence of teaching should include a syllabus of the dysphagia course taught. Research must include clinical research in normal or disordered swallowing with direct contact with human subjects as part of the methodology. OR
b. an official administrative or supervisory position in a setting that provides clinical services to persons with swallowing disorders. Responsibilities will include training and supervision of clinical staff, program development, and leadership in the institution directly related to swallowing and swallowing disorders. Multiple examples and evidence of these areas of leadership must be included in the narrative section of the application (e.g. policy/protocol development regarding swallowing program, development and implementation of dysphagia quality improvement program).

 
 

4. Advanced Skill Documentation

Through the documentation of advanced level skills in swallowing and swallowing disorders, candidates must demonstrate that they have applied the highest level of ethical standards in their practice (i.e. service delivery and in the conduct of scholarship, research, and training). The expectation is that applicants can demonstrate “advanced” clinical and professional skills over the past 3 years. In other words, the applicant has achieved the highest standard of excellence, displays professionalism, is committed to continuous advanced learning, and displays characteristics that reflect achievements that go above and beyond expectations. Applicants may indicate a clinical preference or advanced level of experience in either pediatrics or adults but this is optional as applicants will have knowledge of swallowing and its disorders regardless of age.
There are distinctly different requirements for each track.
a. Applicants in the Clinical Track must evidence advanced skills either by satisfying at a minimum: two activity types within one category or one activity in two different category types. In other words, the applicant can choose to provide documentation in just one of 3 advanced areas.
b. Applicants in the Academic/Administrative Track must evidence advanced skills in at least two different category types.

Yes, Yikes!!! I knew I had the ASHA credentials, I actually did have the continuing ed requirements, the hours of experience (thank you to all my SNF experience and the hospital). My area that I was lacking was my advanced experiences. Nancy gave me some wonderful ideas such as presenting poster presentations at my state convention, at ASHA, presenting within the community. I also added things like my Facebook groups, my Twitter experiences, online journal club. I live and work in a very rural area (25 bed hospital), so some of these advanced skills took some creativity. I also was very fortunate in that at the time I started my application process, I had the opportunity to supervise 2 CF’s and a student. Everything just seemed to come together at the perfect time!

I did end up doing a poster session at my state convention in 2011, then a poster presentation that same year at ASHA. I had the Facebook groups, CF supervision and several experiences with education of nursing staff etc. I felt that I was ready at that point. After sending in four copies of my very lengthy application, submitting my payment for application and several long weeks of waiting, I received a letter in the mail. I wasn’t accepted at that point.

The nicest part of the rejection letter, was that the board didn’t just tell me it wasn’t good enough at that point. They highlighted my areas of weakness and strength with suggestions for improving those weak areas and improving them for future application.

I’ll admit, that I spend a couple of days feeling sorry for myself. I cried a little. After encouragement and support from Nancy, my family and several friends, I decided to get back on it.

After another year of presenting to the community, speaking to a nursing class, reworking my application and basically doing all the things that were suggested by the board, i resubmitted my application. 4 more copies, $75 more, MANY revisions of the application, 4 letters of recommendation and letters from former patients. After an agonizing 8 weeks, I was sitting on the couch one evening, checking my email. I had an email from the BRS-S. MY APPLICATION WAS ACCEPTED!!! I had to email and text everybody I knew!! It was like an absolute dream!

Then came the scary part. I had to pass the exam. What is on the exam?? That is what every person that has not taken the exam would like to know!!! There is a study guide that is submitted with your acceptance email, however, basically, you need to know a little bit of everything about swallowing and dysphagia. I have spent about the last month and a half studying everything I could get my hands on regarding swallowing and dysphagia, pediatrics, Dr. Logemann’s book, journal articles, everything!

I signed up to take my exam on Oct 2. I was a nervous wreck. I couldn’t eat and was just anxious. The time came to take the exam. I signed in (you have 2 hours to take the 110 question exam). I do remember several times thinking, why didn’t I study that more or what in the heck is that?? I actually finished the exam in less than an hour, thinking I would review my answers. I then decided that if I went back over my answers, I would change them and do worse.

I very quickly decided to then click on submit, which I did and waited. My score appeared within seconds, 92%!!!!! I needed an 80% to pass. I could barely believe that I passed!!! I actually obtained Board Recognized Specialty in Swallowing!!

I do believe that anyone who wants to achieve this great honor, should! It is a tough process, it is very taxing, but it is so very rewarding in the end. It is an amazing feeling to know that you have done something that very few people have accomplished at this point.

It is so important in the time of changing health care and the need to “prove” our services, that we have something that we can “prove” the worth of our services and that we are the ones that specialize in the area of swallowing!

2 thoughts on “Journey to the BRS-S

  1. Congratulations!!! 🙂 I'm still in the exploration stage and feeling overwhelmed and almost “stuck” at how to proceed. This post gave me a good, structural framework to think about.

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